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Bilingualism and Autism Spectrum Disorders

Posted on
February 17, 2008 by
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¡Bienvenidos! This month’s topic of discussion is Autism Spectrum Disorders and the Bilingual Individual. Given the increasing number of bilingual children in the United States, and the increasing frequency of autism diagnoses, there is surprisingly little information available for clinicians who work with children who are “on the spectrum” from culturally and linguistically diverse backgrounds.A few of the questions communication professionals may face include:

How do I help these kids navigate the social constructs of two or more cultures?

How do I effectively evaluate pragmatic differences vs. disorders?

What is the home culture’s understanding/beliefs regarding autism and how will it affect assessment and intervention.

And of course, the same question asked of so many bilingual individuals, In which language do I provide treatment?

Sofia Carias, M.S. CCC-SLP, begins this month’s topic. Please take a moment to view her video and weigh-in on the subject with your questions, comments and experiences.

Thanks for participating in the ¡Adelante! forum this month! We have a lot to talk about!
If you would like more information on this topic, please visit the following articles and websites:

Is Bilingualism Detrimental for Children with Autism? Dopke, Susanne (susanne@bilingualoptions.com.au). February 2006.

To Be or Not to be Bilingual: Autistic Children from Multilingual Families. Kremer-Sadlik, Tamar (University of California, Los Angeles). Proceedings of the 4th International Symposium on Bilingualism, 2005.

The first you mentioned (ASD & Learning Foreign Languages), seems like it has some pointers that would be applicable for working with older, sequential bilingual ASD kids as they receive targeted English instruction. A lot of this also seems like it would be a good, practical handout for our General Ed teachers who are working with ASD kids.

I also really like the 2nd article. The principle author (Dr. Taylor-Dyches) will be presenting on this subject at the Bilingual Symposium this summer. I’m looking forward to hearing what she has to say!

Sofia, I have to say that this is an interesting topic. I’m glad to see that you took on this topic. Well done Sofia, it is not easy being the first clinician to present on our Bilingual Therapy Blog. As you mentioned, there is not enough research on the topic of bilingualism and children diagnosed with Autism or Asperger’s. Choosing a language of intervention has to encompass the whole child not just the diagnosis. You mentioned family centered therapy and I agree. In most situations the child will always be cared for by a family member. If the home language is a language other than English, then that is to be taken into consideration as it will result in a disconnect between the child and the caregiver/s. It is never the best recommendation to ask parents to use a language that they do not typically use or have limited proficiency in…not just for children diagnosed with Autism.

Best practice, in my professional opinion would be to incorporate both languages whenever possible in the therapy sessions. Though this is not always possible, it is important for the growth and progress of children with Autism. You mentioned thinking outside of the box and in these situations where bilingual services are not available, it is vital. Using information, software, paraprofessionals, consultants etc. to help support the child, family, and school is an important part of our job.

So often professionals in the educational environment are concerned with “confusing” the child. There is no evidence at this time that children with language or communication disorders have such limited language resources to become bilingual. And this notion of language “confusion” is used all too loosely. In my training with Dr. Kayser and conferences that I have attended throughout my career, all cautioned the use of this term. Typically the children are either disordered or at some stage of their bilingual development.

I have had bilingual children with autism on my caseload at different stages of their development. They have all, to some extent become bilingual. Some both receptively and expressively and others only receptively. There PECS systems were developed in Spanish for home use and bilingually in the Academic setting. When they mastered areas in the dominant language we transitioned those areas into English. I Should mention that the classroom had bilingual aides and at one point a bilingual Special Ed. teacher. It is possible and I have experienced and witnessed it. Having that connection between home and school only enhances and promotes the child’s language.

Hi everyone. I found another couple of resources for those working with CLD kids with Autism Spectrum Disorders.

Last week I had the pleasure of meeting Dr. Celeste Roseberry-McKibbin from Sacramento State. She was presenting the results of a survey done on the knowledge and attitudes of CLD parents of autistic children. It was interesting that these CLD families held similar knowledge and beliefs about the causes and interventions for ASD as “mainstream” U.S. society.

Dr. Roseberry-McKibbin also introduced me to a book she wrote that contains a brief but informative section on working with autistic CLD children. That reference is:
Roseberry-McKibbin, C. (2008). Service Delivery to CLD Students on the Autism Spectrum. In C. Roseberry-McKibbin (Ed.), Multicultural Students with Special Language Needs, 3rd Edition (pp. 385-389). Oceanside, CA: Academic Communication Associates. (ISBN: 978-1-57503-139-2)

What would you say about a family who speaks english as their first langauge but lives in another country and has a child with autism and speech impairment ? We are an American family living in Poland. Our son has autism and a speech impairment. If he is hearing english at home and Polish outside of the home is this too confusing for him? Would it be better for him if we moved back to America?

Great to see this discussion! I’m a doctoral student who has done a couple of case studies on bilingual children with autism and their families. The first study was on the code-switching patterns of a high functioning autistic child in a Chinese-English bilingual home. I found that his code-switching was used as a conversational resource just as has been documented with neurotypical children. The second study examined a Chinese immigrant family of a child with autism and was presented as a poster at the 2008 ASHA conference. The members of this family spoke only English to the child at the advice of teachers and therapists and also because some of the family members worried that the child would be confused by more than one language. The family continued to maintain a primarily Chinese-speaking household, but spoke to the child with autism consistently in English. This language practice was observed to have a significant impact on the interactions within the family. The child was exposed to a limited and highly specified set of interactions and kinds of talk which did not represent the wide range of interactions that were available in his family.

Dzień dobry! We’re glad to have your participation all the way from Poland. Your question is an interesting one. On the surface, it seems like a unique situation. However, I think the recommendations I can give to you are similar to what I would give to, say, a Spanish-speaking family in the States, (and seems to be what has been echoed by other participants on this forum.)

Poland or the US?
I think some of the things that Sofia mentioned apply to your situation. Unfortunately, we don’t have a lot of research on this topic right now. What we do know about bilingualism is that children generally benefit from having a strong home language model when gaining exposure to a second language. The small-scale studies and clinical experiences that I’ve read/heard don’t suggest that bilingualism is detrimental to children with autism. There is even evidence that some of these kids do learn two languages. (Please feel free to check out the references that were cited for more information.) One study that may also be applicable found that bilingual kids with more-severe language disorders, (in this case, Down Syndrome), were able to gain similar language abilities as their monolingual peers. (Kay-Raining Bird, et al., 2005).

In short, we don’t know for sure what effect bilingualism has on your autistic son in Poland, but there is some evidence that being in a bilingual environment may not be “too confusing” for him.

Certainly there are a lot of factors that you and your family will need to consider as you decide whether or not to return to the U.S. As you look at your son’s needs, I would get information from his interventionists about the progress he is making and examine what he is doing with your family. How does he do meeting his needs in and out of the home? What do his interactions look like? Do you believe he is making progress?

When in Poland…
My recommendation for while you are still abroad is actually “don’t necessarily do as the Polish do.” As mentioned earlier, the stronger foundation your son has in his home language, the more resources he will have for learning Polish. Since it sounds like English is mainly spoken at home, I’m guessing you can provide the strongest language model for your son in English. It also seems like English will give him greater access to inter-family communication.

I’m sure that recommendation leads to questions about the benefits of having an “English-only” environment at home. Unfortunately, this is another area where we just don’t have a lot of information on what the best scenario looks like. I’m betting, however, that if there are other kids in the house who are learning/speaking Polish that they may be throwing in some Polish phrases while speaking English. This is called “code-switching” and is frequently seen in bilingual homes. If that is a natural home interaction, I’m not sure you want to prohibit it.

Betty Yu just posted a comment about some studies she has performed. While I’ve only been able to briefly look over the information, she seems to be suggesting that the high-functioning autistic child in her study used “code switching” in a way that typical children did, (which I infer to mean that it was not detrimental). The other study she mentioned suggested that using only one language with an autistic child in a home where two languages were spoken really limited the types of interactions that child could participate in.

So no “for sure” answers, but I hope this information is useful to you. I’d be interested to hear what other participants think. Best of luck to you!

I am so happy to see the topic of bilingual learners with ASD addressed! I am also very involved in this area as a bilingual advocate and educational consultant. I recently completed my master’s thesis on the obstacles faced by Latina mothers of children with autism (articles are pending publication). The results of my study were astounding and I am willing to email my thesis as a pdf to interested parties upon request, at no charge.

I have a son with autism who just graduated from college and will soon take the CPA exam.

I’d like to share a resource for Spanish speaking families of children with autism and Aspergers. Los Trastornos del Espectro del Autismo de la A a la Z aka Autismo A-Z is a comprehensive resource of tremendous value to families and professionals who need to know about ASD and how to help individuals on the spectrum and their families. I am the co-author and translator, and travel around the country as well as to Puerto Rico, Mexico, and Argentina helping to raise awareness and understanding of autism in the Latino community. More info on our book is at http://www.asdAtoZ.com.

Autismo A-Z was recently adopted as a textbook by the Interamerican University of Puerto Rico, and the English version is used as a textbook in the Speech Dept at Boston University. It is the Autism Society of America Outstanding Literary Work of 2006. I hope that bilingual therapists helping Spanish speaking families will find it useful for yourselves and the families with whom you work.

I look forward to continued discussion on the topic of bilingual children with ASD and moving this subject into the public eye with the establishment of best practices.

We all speak English in the home. It is our first language. Our boys are homeschooled and not going to Polish school so they don’t speak Polish. They can understand Polish when it is spoken to them. They know many words but are definitely not fluent. My husband and I both can communicate in Polish. It is a unique situation. Joel’s main exposure is English yet he does not get any English reinforcement outside the home since we live in Poland. I think that his social development impairments which are apart of his autism are not helped by the fact that he can not relate to people outside the home. We do get together with other American families when we can and this helps.

Hi, I found this subject interesting. My son (6 years old) has been diagonised with ASD. We live in India and he goes to a mainstream school as a first grader. India is a country which has a different language in each state. We have migrated from a “Tamil” speaking state to a “Hindi” one. FYI, both Tamil and Hindi are different languages. His school is an English medium with Hindi as a second language. My son is now fluent in all three languages.

Even though he picked up speech later than most kids his age, I never stopped talking to him and encouraging him to talk. He used to observe me talking Hindi to my maid and other visitors. He loved Teletubbies and Bob the Builder which were in English. He slowly picked up words from all three languages.

His school required him to be fluent in English and Hindi. So, when I spoke to him, I would repeat the same line in three languages explaining to him that this is in Hindi, English and Tamil. My husband thought I was overdoing things and preferred me to talk to him only in English. But I thought I’d give it a try. And I think I have been successful, since he has picked up all three languages.

I should also inform you that my son always knew which language to speak to different people from the age of 4. For ex: he only speaks Hindi with visitors, his classmates and my maid. He speaks in English to his teachers and his father and in any language with me.

I think the key is persistence and involvement from all sides. Of course, all this, depends on the child’s existing capabilities also. No use pushing your child too far to prove your point. But I believe there’s no harm in trying out new stuff to find out if he/she is open to it.

There are a lot of bilingual and trilingual autistic children in India as the social setup encourages it to be so. So maybe your studies could approach India for positive results on such children.

I must also inform you that my son still hasn’t lost his baby talk yet. He has a social skills problem and is unable to relate to his peer group. But he does try to mingle with other children – but unsuccessfully. Recently he prefers to play with much younger children tries to avoid playing with his peer group. Even when I take him to the park, he tries to play with the other children for some time. But when he gets rebuffed by them since he’s unable to communicate at their level, he goes away and starts playing alone. Could anyone give me pointers on how to help him here?

I am a bilingual Spanish speech therapist that also specialized in children with autism. My question is posed to parents and professionals alike. I am witnessing on occasion, children with ASD starting to talk for the first time in an English developmental preschool (with Spanish speaking aids interpreting), starting to refuse to speak their home language. One little boy in particular is showing little to no receptive language in Spanish and zero expressive. He is in a 50/50 dual language program in school. I could provide services to him in Spanish but since he only used and (seemed) to understand English, I have been servicing him in English. Mom says he has been this way since he started talking, and she has always had to use his older siblings as interpreters. He is having an extremely difficult time keeping up in his Span. classroom since he does not/cannot participate. Administration wants to keep him dual language; I feel he has made his choice and for academic success, he should move to English only. Mom had expressed this as her desire; she says she is willing to (and knows she will have to) learn English if she ever want to communicate with him directly. We are loosing time with his academics. Ethically I feel I must continue to advocate for him, but am not sure where to turn for support. I don’t know anyone else in my district who provides bilingual services and specializes in autism. I cannot find any research on this particular situation. I want to know if others have observed this, despite 1st language support in school? And as a professional, what would be best practice for him? Thanks!

I am looking for information on how I should approach teaching my 35 month old son (who is not diagnosed with ASD yet, but should be in a few days – we’ve been waiting for months) language and the social skills.

My husband, a native English speaker, uses English with our son and daughter (14 months). I, a native speaker of a Chinese dialect (but whose dominant language is now English), have used my dialect (and signs from ASL) with both my children from their birth. Occasionally I do use French and Spanish with them, but it usually is only with singing songs or reading. More significantly, I have been using much more English because others have told me to forget the Chinese (and also signing) for fear of confusing my son and making him worse.

My son had normal development until about the time my daughter was born (they are 20 months apart). By the time my daughter was born, my son was able to communicate mainly in single words (but he did use two word phrases) in Chinese and signs, but he was also beginning to show that he understood English and could also produced more and more words in English. After my daughter’s birth my son showed a gradual regression in toilet training as well as social and linguistic skills. I was told by many people that it was quite common for children to regress after the birth of a sibling and a move to another home.

Finally we had a developmental specialist see my son, and she recognised that he should receive an assessment/diagnosis as soon as possible. She gave us information on autism, and we have been researching as much as we can about it since then.

My questions are in regards to language:
1. Should I still teach my son in my native language as I have since his birth or should I eliminate it all together? I am concerned that if I completely eliminate Chinese that it would be a shame for him to lose what he has already learned (mostly receptive language), and that he would be more alienated from my side of the family. And ss I will still use Chinese with my daughter, I think it would be difficult for me to switch back and forth.
2. If I do continue with the bilingual teaching, should I stick to Chinese and avoid using English with him, and let my husband use English with him?
3. Should I switch to English instruction, and then as his English improves, should I then reintroduce the Chinese? My concern with this approach is that it is easier for my children to learn English in this country than it is for them to learn Chinese.

My reasons for bringing my children up from birth in two languages and cultures (my husband one language and me the other) are two fold: to give him more options as an adult (more synapses, perhaps more capabilites); and to be able to communicate and relate to my family.

Thank you for your time. If you have any information that could help my situation, please let me know. And thank you for sharing your research and experience on working with autistic children in muliple languages.

Hello from France ! I’m English and speak with my husband in French, my kids in English and they reply in French ! Our last son has been diagnosed with severe language impairment (just 4 yrs old). School, therapist and psychologist etc all have pushed me into stopping English. I’m reintroducing it after a few months ‘just French’ which has been very frustrating for me.
The psy says he has an ‘identity problem’, not yet sure if that’s slight autism or not. couldn’t me speaking in French worsen that for him ?

I am working with autistic students and beside that I need help with a essay that I am doing rigth now Bilingual and Autistic children. I want to know if it is good for them to learn two language . They can do it. They were confused.

I have a Vietnamese family that spoke Vietnamese to their autistic child until he was 3 years old. When he entered school at 3 years of age, the teacher told the parents to only speak English to the child. The boy is now 6 years, 8 months old and his parents are still speaking English only; however it is very broken and limited. The boy’s expressive and receptive language in English is very low. Should he continue speaking in English or should he be introduced again to his primary language? Any help would be greatly appreciated.

Hi Nancy- thanks for posting your question! A recurring theme that I’ve seen in the literature (and on this blog) is that when parents speak only in a language that is less-familiar to them it limits the exposure that the child has to a strong language model, and may keep the child from participating in all the dynamics of family communication. (See Betty Yu’s comment above posted on 5/26/2008). Additionally, Elizabeth Kay-Raining Bird, who published a highly-quoted study on bilingual children with mod-severe language disorders, presented a wonderful session at the ASHA convention in New Orleans last month. She talks about the ability of children with disabilities to manage more than one language, and gave some great insight into many of the dynamics involved in the process (e.g., exposure, family values, motivation for being bilingual, etc.) I highly recommend it; it may lend you some insight into working with these parents. The slides can be found online at: http://convention.asha.org/2009/handouts/1645_1693Kay-Raining_Bird_Elizabeth_071775_Nov23_2009_Time_031839PM.ppt Best of luck as you work with the parents and teachers to provide the richest communication environment possible for this student!

I would like to thank all the participants in this discussion (professionals including our presenter Sofia Carias and parents ) for providing us with a framework and insights/questions on how to best work with bilingual children who have been diagnosed as being on the ASD spectrum –which in itself is a broad classification. Each child is different no matter which diagnosis he/she is given. We need to evaluate each case and collaborate with all persons that work with the child.
In any event, we know from research and experience that all individuals can handle one and more languages–most the world is bilingual or even tri/ multilingual. children. Observations and emergent literature indicates that children with various language disorders can be indeed be bilingual and the exposure to more than one language DOES NOT create further problems. So families and professionals working with a child on the ASD spectrum or any other disability need to engineer the best possible ENVIRONMENT where both languages can be enhanced. What is important, is to provide the children with POSITIVE experiences where each language is nourished and respected, just as a growing plant- in a garden- Henriette W. Langdon, Ed.D. Professor, San José State University, CA,

What about early intervention with Spanish speakers? My autism specialist recommended pairing Spanish and English with my 2 1/2 year old Spanish speaking client, so she could get ready for English preschool. I thought that we should stick to Spanish – and introduce English in home therapy only if she had mastered a concept. I think she will get English soon enough in preschool. Any further thoughts?

I need some direction. I am an S-LP. I am working with a family who have immigrated from India. The 3 yr. old child with ASD receives 12 hours of in-home intervention per week (Pivotal Response Therapy i.e. PRT) and attends and early education classroom 1/2 days. The mother is there throughout his in-home intervention and translates most everything. She intervenes with all behavioural situations. In PRT, the child needs to respond in English, so the language code is continually switched throughout therapy. She also attends his school classes. She sits near him and translates during classtime. I believe in family-based intervention and that L1 is fundamental to a family’s fabric. However, I also believe that our ultimate objective in service-delivery is to continually work toward functional independence. I feel that the mother’s involvement is limiting the child’s progress. In terms of language, I can’t imagine where this is going. I think I need to set up some boundaries with the translation and code-switching, but I need some guidelines. Any thoughts???

I am a graduate student in Wisconsin and am planning on writing my thesis on bilingualism and autism (I am still in the research phase here). I see that there are no clear cut answers about how to go about promoting bilingualism in children with ASD. Language acquisition theory would lead one to believe that the development of a strong L1 will lead to a better outcome in the development of L2. That got me to thinking, if you have a young, completely non-verbal child with ASD that comes from a Spanish speaking home and shows no signs of expressive nor receptive language in Spanish, would it be better to have therapy done to develop receptive and expressive language skills in English rather than in Spanish? Especially if one considers that this child will eventually be attending English speaking schools. Therefore making English the L1 by default and then teaching his/her Spanish speaking family members strategies in which they could teach the child Spanish which would essentially become his/her default L2? OR do you start therapy in the home language (in this case Spanish) with a bilingual autism therapist and gradually add in the English component to the therapy sessions? Having a son with autism, I know that autism comes in all sorts of flavors. Some kids are higher functioning than others. I am not as concerned about a high functioning child with autism or Aspergers, what concerns me more is how to go about therapy with a child that is low to moderate on the autsim specrtrum.

To. KIM
I have a 5 year old autistic son. I used to speak Thai with him when he was a baby but I was suggested to stop by my friend as it would make him talking slower. I stopped it for 3 years but only when we went back to Thailand I spoke Thai with him and only English in the uk. Now I had another child and I regreted about it. Autistic children can learn two languages without a dount. I now speaking Thai at home with them and no longer in English. I only speak English to my husband and my English friends.

Speaking English to your son and Chinese to your daugther it would make him feel even more isolated. Just carry on your home language Kim and let their dad speaking English. I don’t see the point to rush your children to speak as they will be one day picking it up even though your son has autism or not. Remember you are giving them the best by speaking your home language.

I teach children with autism in a bilingual school. I am also hearing impaired and when younger presented a problem with auditory processing. I remember going to speech and language therapies. My mother was a teacher in her country Cuba and only spoke Spanish. In school it was difficult I learned slower but learned both languages. I remember about 10th grade I started learning more Spanish and my culture and the English language learning decreased but that was just for a few years. I am now fully bilingual. I am still working on my Spanish reading and writing because I received less instruction in these. Since college I have also taken up other languages ASL to help with my hearing deficits and Chinese because I just want to challenge myself. Yes it has always been more difficult to learn but as I learned more languages I felt like it became easier to learn them because I had more of a repertoire of sounds and perhaps dialects in my knowledge. I have experienced telling myself oh that sounds like this sound in Chinese. Which in a weird way has helped me to speak better even my native language. I believe if I would have been English only speaking my relationship with my family or chances of learning cultures even my own at home would have been hindered. I am glad my mom against all advice exposed me to Spanish and English even though it may have slowed the learning at one point in my life but it helped me to connect culturally later on. I believe being bilingual has strengthened my capability to learn languages even though it continues to be difficult. I believe as a teacher the more we expose children to the better especially if they are speech or language, hearing impaired or have processing issues like me. Unfortunately I have not seen any research to support this but have experienced it in my own life. My students with autism use native language, English and a lot of babble but eventually when they are ready I believe they will use what they know in any language to communicate because the most important thing is for children with autism is to communicate it doesn’t really matter if it is in native language or exposed language and how good it would be to let them pick which is easier or more convenient for them in their lives.

Thanks for sharing your story Lidia! There are a couple of studies that were published recently that I think support the experiences you mentioned (and the ones that we as professionals frequently witness).

There are the case studies Dr. Yu mentioned above- one of which observed how much rich language an autistic child was missing out on in the home by only being spoken to in English.

Another was published by Hambly and Fombonne (2012) that showed that children on the autism spectrum who had to navigate bilingual environments did not experience additional language delays when compared to monolingual children with autism. (http://www.ncbi.nlm.nih.gov/pubmed/21938563)

Also, Bunta and Douglas published an article last summer (2013), which showed that bilingual children with hearing loss who used listening devices performed similarly to monolingual children on language tasks. They proposed that both languages can be supported without adverse effects and that there are a number of additional benefits that come from supporting bilingualism in children with hearing loss. (http://lshss.pubs.asha.org/article.aspx?articleid=1797453&resultClick=1).

It’s great to see a growing body of research that supports the things that teachers like you have been practicing.

My son is in a dual immersion program in Glendale CA, called Benjamin Franklin Magnet Elementary School. He is 8 and has ADHD and is on the Autism spectrum. We moved to Glendale in 2013 from Paris where my children’s first language was French. He is high functioning verbal and speaks both languages.
He has a IEP (special ed plan) and receives speech and OT services all in English only. The school district GUSD finally accepted to give him a one on one BI (Behavioral Interventionist, much like an ABA therapist but not as qualified) to help him stay on task which they determined to be the reason he is behind and can not keep up with the curriculum. Unfortunately they refuse to hire someone who speaks the language of the classroom, in our case French. 80 % of my sons day is in French at his school. The district claims that “English is the language of instruction in California” and therefore they are not obligated to provide any special ed in any language other than English. Each time I ask for an aide who speaks french The district tells me NO and that the best solution is to drop the french and put him in an English only school. My son has outside ABA with therapists but none of them speak french. In Los Angeles there are 10,000 “francophones” (french speakers) so it is not impossible to find someone. Of course it is easy to find Spanish and Armenian speaking teachers therapists and aides here.
Questions: Is anyone reading this receiving an aide or any special ed in a language other than English?
Does my son have the same right as other children to be in an immersion program?
What evidence can I present that supports the benefits of bilingualism for children on the spectrum or with learning disabilities?